Entries by Lori Klink

Segmental lumbar spine instability at flexion-extension radiography can be predicted by conventional radiography.

Pitkanen MT et al. Clin Radiol Jul;57(7). 2002An interesting study to identify plain radiographic findings that predict segmental lumbar ‘instability’ as proven via flexion-extension radiography. The ‘instability’ was classified into either anterior or posterior “sliding”.The authors noted: “sliding instability is strongly associated with various plain radiographic findings. In mechanical back pain, functional F/E radiographs should […]

Centralization and directional preference…again

Manual therapy 17, 2012 When we take the time to examine patients’ preferential motions (very often extension and lateral bending) and prescribe them for daily repetition we can typically improve response and reduce therapy dependence or iatrogenic chronicity. Centralization is a symptom response to repeated or sustained movements that can be used to classify patients into sub-groups, […]

Lesegue sign a.k.a. straight leg raise

Wikipedia is always an interesting place to learn pointless facts: e.g. Dr. Leseque actually suggested extending the lower leg after the thigh was flexed…NOT the traditional SLR ….Dr. Laza Lazarevic actually described the traditional SLR we typically use today. Both are assumed relevant to determining an L5 (but less L4) disc herniation and/or nerve root […]

A brief critique of FMS (Functional Movement Screen):

Anoop Balachandran MSc (ex):“Why should mechanical stress caused by “faulty movement patterns” always “lead to microtrauma & injury” as proposed by systems like FMS? Why can’t tissues just positively adapt and get stronger just like a normal biological tissue? IF indeed faulty movement patterns were the cause of injury, all those cerebral palsy patients, stroke […]

Comparison of intervertebral disc spaces between axial and anterior-lean cervical traction

Chin-Teng Chung et al. Eur Spine 18;(10) 2009.There have been minimal investigations as to the changes in spinal structures during traction which may prevent exploration of the possible therapeutic mechanism of cervical traction. 96 radiographs were reviewed comparing axial to anterior-lean (AL). This entails the patient seated and facing the traction apparatus (as opposed to […]

Why I choose the ‘simple’ patient classification of Compression vs. Motion disorder

Reliability of chiropractic methods commonly used to detect manipulable lesions in cLBPFrench SD et al. JMPT May; 23(4) 2001Intraexaminer and interexaminerreliability of static spinal palpation: a literature synthesisNaneline MT, Young M. JMPT Jun;32(5) 2009Results: Commonly used chiropractic diagnostic methods in patients with LBP to detect manipulable lesions are NOT reproducible. These procedures do not provide […]

From Michelle Cameron MD: Clinical modalities; lumbar mechanical traction

Cameron’s book on physical agents for rehabilitation echo’s many of the tried & true clinical suggestions that I and others in the ‘decompression industry’ also recommend.  “Optimal patient positioning: try to achieve a comfortable position allowing and muscle tension to relax, allowing separation of the vertebra. The relative degree of flexion or extension can determine […]

And from the: “get a load of this!” file…. A commentary from Science-based medicine webpage regarding CAM

“Many MDs have relied heavily on the American Academy of Family Physicians for continuing medical education via the American Family Physician and the AAFP home study programs. The AAFP prides itself on its evidence-based approach to medicine. In general, it delivers. But the recent FP Essentials Number 432 on “Chronic Pain Management” fell short. It recommended treating chronic […]